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Popov I.,University Hospital Prof Dr St Kirkovich | Zheliazkov R.,University Hospital Prof Dr St Kirkovich | Ivanova D.,University Hospital Prof Dr St Kirkovich | Shomov G.,University Hospital Prof Dr St Kirkovich
Nephrology, Dialysis and Transplantation | Year: 2015

Malignant melanoma is one of the most invasive malignant tumors that have the tendency to avoid the defense mechanisms in the human body. Its resistance to conventional therapies is also well-known. The presented clinical case is based on a 73 year-old patient with malignant melanomawith acute renalfailure, accompaniedby chronicpyelonephritis, cholecystitis calculosa, hypertonia arterialis, and hepatitis reactiva. Initial symptoms dated from February 13, 2014, as the patient was experiencing pain in the epigastrium and right rib cage area, and nausea with repeated vomiting. The patient was admitted with an initial diagnosis of gall bladder stones and cholecystitis. Creatinine level at the time of admission were 416 nmol/l. Treatment was started at the time of admission. Previous anamnesis was gout with chronic pyelonephritis. At the time of release, patient creatinine level was 606 nmol/l. Although patient pain levels were managed and significantly reduced, the patient continued to experience persistent nausea, and general asthenia. Several days later, the pain levels had increased, and the patient was declining food and liquid intake. Decreased urine quantity was determined (150 ml urine was excreted during catheterization). At that time, test results were as follows: creatinine 1103 nmol/l, urea 51.7 mmol/l, potassium 7.61 mmol/l. The treatment team of physicians suspected carcinoma with an undetermined primary focus, with carcinomatosis and ascites with meta hepatis. Although alternative methods were discussed, a standard evaluation ofthe pigmented lesions was performed via histopathology examination with microscope. Results from the histopathology test showed metastatic melanoma in the kidneys, lungs, liver, myocardium, and spleen. The new patient treatment involved the latest immunotherapeutic therapy to recover the T-cell response toward the tumor cells, in order to supply enough immunocytes to attack the melanoma cells.

Dimitrov N.,University Hospital Prof Dr St Kirkovich | Goycheva P.,University Hospital Prof Dr St Kirkovich | Petrov D.,Trakia University
Journal of the Balkan Tribological Association | Year: 2015

Osteoporosis is a major health concern in almost all industrialised countries. Osteoporotic fractures impacts many areas of patient lives, such as work and role functioning, emotional, and social wellbeing. This study aims to assess the health status and the quality of life (QoL) in male patients with major osteoporotic fractures after the incident of the fractures and at the 6th month after surgical treatment, using two generic measurements: The EuroQoL five dimension questionnaire (EQ-5D) and the Health Utility Index Mark 3 (HUI3) Classification System. We observed severely impaired QoL in patients with osteoporosis related fractures. We also showed that surgical treatment was associated with marked improvement in the patients QoL status. The study is a first step in exploring the health status in disabling conditions, such as major osteoporotic fractures in Bulgarian population.

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